I get our anger and frustration over the issue. But the claims forms (CF1, CF2, CF3, CF4) are not there to make it "easier" for PhilHealth to pursue corrupt practices. Actually, the forms are there to safeguard the interests of PhilHealth members by allowing the hospital to declare that the standards of care have been … Continue reading On the corruption allegations against PhilHealth
Philhealth
PhilHealth should provide incentives to eliminate out-of-pocket expenses
PhilHealth has instituted a no copayment policy for its benefit packages for the diagnosis and management of COVID-19. The costing of these benefit packages is a result of an iterative process involving data collection, stakeholder consultations, and data analysis. As such, we can say that the “maximum” health care cost for a specific service (e.g. … Continue reading PhilHealth should provide incentives to eliminate out-of-pocket expenses
Pen Point 49
Various provider payment mechanisms will continue to exist in the country’s health care system. Emphasis is placed, however, on the current movement towards using performance-driven, prospective payments (e.g. Global Budget Payment) based on diagnosis-related groups (DRG). The shift to DRG-based GBP will not be easy. Mechanisms should be in place to avoid underprovision and ensure … Continue reading Pen Point 49
Health Economics Series: Provider Payment in the UHC era
The country is considering several options for provider payment reform that will help achieve universal health care. Population-based interventions will be primarily offered by the government. As such, provider payment mechanism for these interventions will include salary and capitation. Philhealth considers primary health care capitation to promote integrated care through the service delivery network; thus, … Continue reading Health Economics Series: Provider Payment in the UHC era
Free-rider Problem in the Philippine Health Care System
From an economic perspective, the production of public goods can lead to a market failure. A market fails when the free market economy does not achieve efficient results. Such failure can be attributed to the free-rider problem. A public good has a classic free-rider problem because of its two characteristics: non-excludability and non-rivalry. A good … Continue reading Free-rider Problem in the Philippine Health Care System
Pens & Needles 